Successful Common Carotid Interposition Graft Using Proximal Saphenous Vein in a Patient with Cervical Gunshot Injuries: A Case Report

Tadayon, Niki; Shahsavari, Saleh; Jadidian, Faezeh; Khoshmohabat, Hadi; Babaeei, Masoud

doi:10.30491/tm.2023.415012.1641

Successful Common Carotid Interposition Graft Using Proximal Saphenous Vein in a Patient with Cervical Gunshot Injuries: A Case Report

Document Type : Case Report

Authors

Niki Tadayon ¹

Saleh Shahsavari ²

Faezeh Jadidian ³

Hadi Khoshmohabat ⁴

Masoud Babaeei ²

¹ Assistant Professor of Vascular Surgery, Department of General and Vascular Surgery Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.

² General Surgery Resident, Department of Surgery Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.

³ School of Medicine, Shahid Beheshti University of Medical Sciences(SBMU), Tehran, Iran.

⁴ Trauma Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.

10.30491/tm.2023.415012.1641

Abstract

Introduction: Gunshot injuries to the head and neck usually result in severe trauma due to damage to major vessels and pose challenging surgical management. A penetrating neck injury places numerous organs at a significant risk.
Presentation: We present a 39-year-old female transferred to the level I trauma center due to multiple pellet injuries to the neck and jaw.
Diagnosis: Computed tomography (CT) angiography showed the presence of multiple metal densities, an intimal flap, and a local thrombus in the left common carotid artery.
Intervention: The patient underwent surgical exploration, which revealed neck hematoma and near-total transection of the left common carotid artery. She received a carotid interposition graft (CIP) using the greater saphenous vein to reconstruct the artery.
Outcomes: Following an uneventful recovery, the patient was discharged three days after the surgery without any neurological side effects or hematoma. A follow-up CT angiography six weeks after the discharge showed a successful graft.
Conclusion: This case presents a rare scenario of a penetrating neck injury with foreign objects in zone 2, necessitating a specialized surgical approach. Therefore, it contributes to the current literature and aids surgeons in managing similar patients.

Keywords

Carotid Artery Injury

Gunshot Wound

Saphenous Vein Graft

Vascular Reconstruction

Case Report

Subjects